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Finance/RCM (102)

3:57

CMS seeks help to CRUSH Medicare and Medicaid fraud

Kimberly Brandt, CMS COO, discusses the agency's Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) fraud-fighting initiative and invites the public to submit ideas on how to improve its efforts.

CMS seeks help to CRUSH Medicare and Medicaid fraud
Kimberly Brandt, CMS COO, discusses the agency's Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) fraud-fighting initiative and invites the public to submit ideas on how to improve its efforts.
3:57
5:29

Clearer pricing empowers patients to plan care

Point-of-Care Partners' Vanessa Candelora says price transparency for services and medications will make it possible for patients to budget for procedures and to shop for better prices with providers in their insurance network.

Clearer pricing empowers patients to plan care
Point-of-Care Partners' Vanessa Candelora says price transparency for services and medications will make it possible for patients to budget for procedures and to shop for better prices with providers in their insurance network.
5:29
5:04

Elimination of inpatient-only procedures comes at a cost for hospitals

The phase-out of the Medicare Inpatient-Only list drives value and efficiency, but hospitals lose out on volume and revenue, says Allison Oakes, chief research officer for Trilliant Health.

Elimination of inpatient-only procedures comes at a cost for hospitals
The phase-out of the Medicare Inpatient-Only list drives value and efficiency, but hospitals lose out on volume and revenue, says Allison Oakes, chief research officer for Trilliant Health.
5:04
5:46

WISeR model is an attempt by CMS to reduce spending in Medicare

CMS says about 25% of the spend is fraudulent or being abused by providers, says Carol Howard, vice president of innovation and adoption at Janus Health.

WISeR model is an attempt by CMS to reduce spending in Medicare
CMS says about 25% of the spend is fraudulent or being abused by providers, says Carol Howard, vice president of innovation and adoption at Janus Health.
5:46
13:49

Is MENA healthcare outgrowing the EMR?

MENA-based healthcare organizations are creating fully connected digital ecosystems and shifting to value-based care. Because of this, Mazin Gadir of Alvarez & Marsal says basic EMRs are no longer enough for these health systems.

Is MENA healthcare outgrowing the EMR?
MENA-based healthcare organizations are creating fully connected digital ecosystems and shifting to value-based care. Because of this, Mazin Gadir of Alvarez & Marsal says basic EMRs are no longer enough for these health systems.
13:49
3:36

Physicians could be missing billable opportunities for remote monitoring devices

Electrophysiologists, who implant devices such as pacemakers, need technology to automatically determine when the billing period ends, says Sallie Gustafson, RN, director of Medical Affairs at Murj.

Physicians could be missing billable opportunities for remote monitoring devices
Electrophysiologists, who implant devices such as pacemakers, need technology to automatically determine when the billing period ends, says Sallie Gustafson, RN, director of Medical Affairs at Murj.
3:36
4:58

Missed revenue opportunities for remote monitoring devices

A Murj survey verified billing is the undisputed top concern for electrophysiologists, says Sallie Gustafson, RN, director of Medical Affairs at Murj.

Missed revenue opportunities for remote monitoring devices
A Murj survey verified billing is the undisputed top concern for electrophysiologists, says Sallie Gustafson, RN, director of Medical Affairs at Murj.
4:58
7:52

AI is driving down clinical denial rates

Todd Van Meter, CEO of Accuity, says that when partnering with clients, initial clinical denial rates are nearly cut in half and following an appeals process using an AI-driven platform, the final denial rates end up at 1% to 1.5%.

AI is driving down clinical denial rates
Todd Van Meter, CEO of Accuity, says that when partnering with clients, initial clinical denial rates are nearly cut in half and following an appeals process using an AI-driven platform, the final denial rates end up at 1% to 1.5%.
7:52
12:58

Looking back on a busy year for healthcare innovation

Join the editors of the HIMSS Media brands for a wide-ranging discussion about an eventful 2025 for digital health transformation: regulatory and reimbursement changes, cybersecurity challenges and, yes, a whole lot of AI.

Looking back on a busy year for healthcare innovation
Join the editors of the HIMSS Media brands for a wide-ranging discussion about an eventful 2025 for digital health transformation: regulatory and reimbursement changes, cybersecurity challenges and, yes, a whole lot of AI.
12:58
5:04

AI arms race between providers and payers needs accurate coding

Arintra aims to be a bridge for aligned incentives and shared transparency for accurate, compliant and explainable coding, says CEO Nitesh Shroff.

AI arms race between providers and payers needs accurate coding
Arintra aims to be a bridge for aligned incentives and shared transparency for accurate, compliant and explainable coding, says CEO Nitesh Shroff.
5:04
6:18

Preparing for the new Medicare prior auth model

Providers in six states face new financial risks and training burdens under mandatory WISeR review, which leverages machine learning to control costs and expedite care. It's going to be "a steep learning curve," says Jeff Ladner, CPO at Onspring.

Preparing for the new Medicare prior auth model
Providers in six states face new financial risks and training burdens under mandatory WISeR review, which leverages machine learning to control costs and expedite care. It's going to be "a steep learning curve," says Jeff Ladner, CPO at Onspring.
6:18
3:27

Accurate provider directories are needed for patient access

The work of updating provider directories is the responsibility of payers, and much of it is still being done manually with mistakes incurring heavy penalties, says Megan Schmidt, CEO at Madaket Health.

Accurate provider directories are needed for patient access
The work of updating provider directories is the responsibility of payers, and much of it is still being done manually with mistakes incurring heavy penalties, says Megan Schmidt, CEO at Madaket Health.
3:27
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Play video CMS seeks help to CRUSH Medicare and Medicaid fraud
Finance/RCM
CMS seeks help to CRUSH Medicare and Medicaid fraud
Play video Clearer pricing empowers patients to plan care
Finance/RCM
Clearer pricing empowers patients to plan care
Play video Elimination of inpatient-only procedures comes at a cost for hospitals
Finance/RCM
Elimination of inpatient-only procedures comes at a cost for hospitals
Play video WISeR model is an attempt by CMS to reduce spending in Medicare
Finance/RCM
WISeR model is an attempt by CMS to reduce spending in Medicare

View more in Finance/RCM (102 videos)

13:49

Is MENA healthcare outgrowing the EMR?

MENA-based healthcare organizations are creating fully connected digital ecosystems and shifting to value-based care. Because of this, Mazin Gadir of Alvarez & Marsal says basic EMRs are no longer enough for these health systems.

Is MENA healthcare outgrowing the EMR?
MENA-based healthcare organizations are creating fully connected digital ecosystems and shifting to value-based care. Because of this, Mazin Gadir of Alvarez & Marsal says basic EMRs are no longer enough for these health systems.
13:49
3:36

Physicians could be missing billable opportunities for remote monitoring devices

Electrophysiologists, who implant devices such as pacemakers, need technology to automatically determine when the billing period ends, says Sallie Gustafson, RN, director of Medical Affairs at Murj.

Physicians could be missing billable opportunities for remote monitoring devices
Electrophysiologists, who implant devices such as pacemakers, need technology to automatically determine when the billing period ends, says Sallie Gustafson, RN, director of Medical Affairs at Murj.
3:36
4:58

Missed revenue opportunities for remote monitoring devices

A Murj survey verified billing is the undisputed top concern for electrophysiologists, says Sallie Gustafson, RN, director of Medical Affairs at Murj.

Missed revenue opportunities for remote monitoring devices
A Murj survey verified billing is the undisputed top concern for electrophysiologists, says Sallie Gustafson, RN, director of Medical Affairs at Murj.
4:58
7:52

AI is driving down clinical denial rates

Todd Van Meter, CEO of Accuity, says that when partnering with clients, initial clinical denial rates are nearly cut in half and following an appeals process using an AI-driven platform, the final denial rates end up at 1% to 1.5%.

AI is driving down clinical denial rates
Todd Van Meter, CEO of Accuity, says that when partnering with clients, initial clinical denial rates are nearly cut in half and following an appeals process using an AI-driven platform, the final denial rates end up at 1% to 1.5%.
7:52
12:58

Looking back on a busy year for healthcare innovation

Join the editors of the HIMSS Media brands for a wide-ranging discussion about an eventful 2025 for digital health transformation: regulatory and reimbursement changes, cybersecurity challenges and, yes, a whole lot of AI.

Looking back on a busy year for healthcare innovation
Join the editors of the HIMSS Media brands for a wide-ranging discussion about an eventful 2025 for digital health transformation: regulatory and reimbursement changes, cybersecurity challenges and, yes, a whole lot of AI.
12:58
5:04

AI arms race between providers and payers needs accurate coding

Arintra aims to be a bridge for aligned incentives and shared transparency for accurate, compliant and explainable coding, says CEO Nitesh Shroff.

AI arms race between providers and payers needs accurate coding
Arintra aims to be a bridge for aligned incentives and shared transparency for accurate, compliant and explainable coding, says CEO Nitesh Shroff.
5:04
6:18

Preparing for the new Medicare prior auth model

Providers in six states face new financial risks and training burdens under mandatory WISeR review, which leverages machine learning to control costs and expedite care. It's going to be "a steep learning curve," says Jeff Ladner, CPO at Onspring.

Preparing for the new Medicare prior auth model
Providers in six states face new financial risks and training burdens under mandatory WISeR review, which leverages machine learning to control costs and expedite care. It's going to be "a steep learning curve," says Jeff Ladner, CPO at Onspring.
6:18
3:27

Accurate provider directories are needed for patient access

The work of updating provider directories is the responsibility of payers, and much of it is still being done manually with mistakes incurring heavy penalties, says Megan Schmidt, CEO at Madaket Health.

Accurate provider directories are needed for patient access
The work of updating provider directories is the responsibility of payers, and much of it is still being done manually with mistakes incurring heavy penalties, says Megan Schmidt, CEO at Madaket Health.
3:27